Exclusive: GP groups cover most of England but ‘lack ambition and priorities’

HSJ has analysed information covering all 209 CCG areas – giving the most comprehensive picture to date of the federations, networks and super practices operating across England.

The work identified 268 of these organisations across 171 CCGs. Our analysis suggests:

• 41 million people – or 75 per cent of England’s population – are covered by a group. This is based on extrapolation from population information provided for 179 groups, which shows an average of 153,450.
• Around 5,750 practices – 73 per cent – are members of one of the groups. This is based on extrapolation from membership data covering 204 groups.
• Twenty-one federations were in the process of being created in second half of 2015, during the period HSJ was collecting data.

HSJ’s map shows the groups we have identified in each clinical commissioning group area. 

The findings come amid a major national push to join up and increase the size of GP practices. NHS England chief executive Simon Stevens told HSJ last month he wanted to see proposals for advanced, large scale GP providers formed across a “reasonable chunk” of the country in 2016.

Despite the wide coverage of groups identified by HSJ, the analysis suggests there is large variation in the functions they carry out.

Information on functions was provided for 110 GP groups and no single function was shared across more than half. The most common, listed for 55 groups, was providing extended primary care, for example long term conditions treatment, urgent care or services for the frail elderly. Many CCGs provided no information on the functions of the GP groups in their area.

The graph below shows the most commonly identified functions.

Mike Bewick, a former national deputy medical director at NHS England and GP, who is now working as an adviser, told HSJ the research raised concerns about “a lack of ambition and clear priorities” among GP groups.

Dr Bewick said: “While there were common themes such as improvement in health outcomes, improved clinical governance, improved access over seven days and seasonal issues, the most common theme was ‘no plan at all’.”

He said: “With the exceptions above, at this moment there is a lack of ambition and clear priorities. This may come with time, but in the context of the Five Year Forward View that time is marching on.

“Simon Stevens has asked for new leadership [in extended primary care] and while this may be obvious in the publicised vanguards, it is less so from this [analysis]. It is important that federations lead the way in service change rather than following it.”